| NPI | 1053756353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MCPHILLIPS Director 941-953-9559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL OT - 0000712) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |